Clinical and prognostic significance of t(4;14) translocation in multiple myeloma in the era of novel agents

• Published in: International journal of hematology Vol. 113; no. 2; pp. 207 - 213
• Main Authors: Sato, Shuku, Kamata, Wataru, Okada, Satomi, Tamai, Yotaro
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01-02-2021; Springer Nature B.V
• Subjects: Autografts; Confidence intervals; Drugs; Hematology; Hematopoietic stem cells; Immunoglobulin A; Immunoglobulin G; Immunosuppressive agents; Immunotherapy; Medical prognosis; Medicine; Medicine & Public Health; Monoclonal antibodies; Multiple myeloma; Multivariate analysis; Oncology; Original Article; Stem cell transplantation; Stem cells; Survival; Targeted cancer therapy; Translocation; Transplantation; Prognosis; Novel drugs; Daratumumab; Multiple myeloma; Overall response rate; t(4;14) translocation; Overall survival
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-020-03005-6

Translocation t(4;14) is an independent prognostic factor for adverse outcome in multiple myeloma (MM). However, reports concerning the therapeutic effects of novel drugs on t(4;14) MM are few. We retrospectively investigated the clinical and prognostic significance of symptomatic MM cases with t(4;14) treated with novel therapies. Ninety-three patients (IgG, 56; IgA, 23; BjP, 14) newly diagnosed with MM were included (median age, 71 years; median observation period, 27.8 months). t(4;14) MM was diagnosed in 17 (IgG, 7; IgA, 9; BjP, 1) patients (18%). An association between t(4;14) and the IgA isotype was confirmed (
p
 = 0.02). Overall survival (OS) at 3 years was lower in the t(4;14) patients than without t(4;14) group (81.2% vs 66.7%,
p
 = 0.04). Multivariate analysis showed that t(4;14) was an independent predictor of OS (hazard ratio [HR], 7.58; 95.0% confidence interval [CI], 1.43–39.9;
p
 = 0.0017). The ORR after autologous blood stem cell transplantation (ASCT) did not differ with or without t(4;14); progression-free survival tended to be prolonged in the group without t(4;14) (
p
 = 0.088). Thus, even in the era of novel drugs, t(4;14) MM still has a poor prognosis, and triplet consolidation therapy should be continued.